IN THE CASE OF:
BOARD DATE: 11 June 2015
DOCKET NUMBER: AR20150006212
THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:
1. Application for correction of military records (with supporting documents provided, if any).
2. Military Personnel Records and advisory opinions (if any).
THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:
1. The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition.
2. The applicant states, in effect, the case file should be reviewed in accordance with the Secretary of Defense directive for a comprehensive review of members who were referred for a disability evaluation between 11 September 2001 and
30 April 2012 and whose MH diagnosis was changed during that process.
3. The applicant submitted an application through the DOD Physical Disability Board of Review (PDBR) Mental Health Special Review Panel (SRP).
CONSIDERATION OF EVIDENCE:
1. The PDBR SRP conducted a comprehensive review of the applicants submissions and records for evidence of inappropriate changes in the diagnosis of a MH condition during processing through the military disability system.
2. The Department of Defense memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of MH diagnoses for service members completing a disability evaluation process between 11 September 2001 and 30 April 2012 in order to determine if service members were disadvantaged by a changed diagnosis over the course of their physical disability processing.
3. In the processing of this case, an advisory opinion was obtained from the PDBR SRP and the applicant was provided a copy.
4. The applicant did not respond to the advisory opinion.
DISCUSSION AND CONCLUSIONS:
1. After a comprehensive review of the applicants case, the SRP determined by unanimous vote that there be no change of the applicants disability and temporary disability retirement determination.
2. The SRP reviewed the records for evidence of inappropriate changes in
diagnosis of the MH condition during processing through the Disability Evaluation System (DES). The evidence of the available records show diagnoses of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), adjustment disorder and cognitive disorder not otherwise specified (NOS) (medical evaluation board (MEB)) were rendered during the DES process. The first psychiatric narrative summary examination listed a diagnosis of PTSD, but the MEB and the physical evaluation board (PEB) only identified major depression and cognitive disorder. The SRP concluded a MH diagnosis was eliminated to the applicants possible disadvantage in the disability evaluation process. Therefore, the applicant met the inclusion criteria in the Terms of Reference of the MH Review Project.
3. The SRP agreed however that the psychiatrists addendum on 26 November 2008 provided a preponderance of evidence that the diagnosis of PTSD was not
supported (did not have evidence of Criteria A1 or A2) at the time of separation and that diagnoses of MDD and cognitive disorder were correct. The SRP first considered whether the MH conditions were appropriately subsumed by the PEB
under the 5025 code (fibromyalgia (FM)). This code stipulated that the widespread pain characteristic of FM may be associated with other symptoms including fatigue, sleep disturbance, depression, or anxiety. Although the code provided the latitude to incorporate mental symptoms, the Department of Veterans Affairs (VA) declined to do soand assigned separate ratings for FM and PTSD.
4. The SRP agreed with the PEB that subsuming MDD and cognitive disorder under the FM condition was appropriate. The rheumatologist noted that the applicant developed a number of medical and psychiatric symptoms at the time of a flare-up of her FM condition during and after deployment. The applicant had no previous MH diagnoses except for adjustment disorder, which not coincidentally occurred years previously during an FM flare. In the context of the other typical symptoms of FM in this case, a conclusion that the mental symptoms component was not unusual or extraordinary was supported by the fact that the applicant only identified pain conditions (including FM) as impediments to working in her primary specialty. The SRP noted that assigning multiple ratings for separate FM symptoms (including mental symptoms) runs the considerable risk of pyramiding, and was to be avoided in accordance with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.14. However, it was noted for the record that rendering a rating recommendation for FM was outside the SRPs scope.
5. After due deliberation in consideration of the preponderance of the evidence, and mindful of VASRD Section 4.3 (reasonable doubt), the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication of the MH condition as part of the FM condition at the time of placement on the Temporary Disability Retired List (TDRL).
6. The available evidence shows the SRPs assessment should be accepted.
BOARD VOTE:
________ ________ ________ GRANT FULL RELIEF
________ ________ ________ GRANT PARTIAL RELIEF
________ ________ ________ GRANT FORMAL HEARING
____x____ ___x____ ________ DENY APPLICATION
BOARD DETERMINATION/RECOMMENDATION:
The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned.
_______ _ __x_____ ___
CHAIRPERSON
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.
ABCMR Record of Proceedings (cont) AR20040003532
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20150006212
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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